19 - Critical Appraisals Flashcards Preview

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Flashcards in 19 - Critical Appraisals Deck (19)
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1
Q

What is a critical appraisal?

A

The use of explicit, transparent methods to assess the data in published research to judge it’s trust worthiness and its value and relevance in a particular context

2
Q

How do you develop your question in a critical appraisal?

A
3
Q

How do we find evidence to use in our critical appraisals?

A
  • Use things like Pubmed, Cochrane Library, NHS evidence
  • Is article relevant to my interests?
  • Is there a clear research question?
  • When was it published?
  • Has it been peer reviewed?
4
Q

What are some reasons that articles get rejected from being included in a critical appraisal?

A
5
Q

What is the process involved in a critical appraisal?

A
6
Q

How can you quickly narrow down whether you want to include a paper in your critical appraisal?

A
  • Research question and aim at end of background/introduction and you should be able to answer PICO with this
  • Is the primary outcome easy to identify?
  • Is the study population easy to generalise or applicale to your population of interest?
7
Q

Once you have figured out if a paper answers your PICO, what are some other factors you need to consider when deciding whether to include the paper in your critical appraisal?

A

- Selection bias: is how the study sample was develped described? is there a difference between people who have been selected and who hasn’t?

- Data collection: is the data self reported? does the data rely on recall? were validated (e.g piloted questionnaires) tools used? what was the response rate and what do we know about non-responders? how many dropped out?

- Confounding: are confounders discussed and adjusted for?

8
Q

What are we most concerned about when appraising a cross sectional study?

A

Cannot see temporal sequence with these studies as outcome and exposure measured at same time

9
Q

What are some issues when we appraise ecological studies?

A
10
Q

What are some critical appraisal tools we can use?

A
  • CASP programme
  • Newcastle-Ottowa Scale
11
Q

What is the outcome measure of a case control study?

A

Odds ratio

12
Q

What are some issues we are concerned about when we appraise a case control study?

A
  • Need a clear case and control definition
  • Have they used medical records or self report to record exposure
  • All the usual e.g is confounding discussed?
  • Do they justify the number of cases and controls used?
13
Q

What is the outcome measure of a cohort study?

A
  • Allows for temporal sequence
  • Odds ratio
  • Risk ratio
  • Incidence rate ratio
14
Q

What are some issues we are concerned about when we appraise a cohort study?

A
  • Are the exposed cohort from the same community as the non-exposed?
  • If it is a historical cohort how was the data collected and how complete is it?
  • Was the follow up period long enough?
  • Can we be sure the participants were outcome free at the start of the study?
  • Was follow up of participants adequate?
  • What is the key finding, how precise is it and how applicable are the results to your population of interest?
15
Q

What should be the analysis in an RCT?

A
  • Robust randomisation eliminates confounding so do intention to treat analysis to preserve randomisation to allow causal inferences to be made
  • Blinding not always possible but if it is it eliminates bias
16
Q

What are some issues we are concerned about when we appraise a RCT?

A
17
Q

What are some of the key questions we need to ask when appraising a RCT?

A
18
Q

What do systematic reviews help to do and what are some issues we are concerned about when we appraise them?

A

Help to identify gaps and areas for further research

19
Q

What are some of the key questions that we need to ask when appraising a systematic review?

A